Provider Demographics
NPI:1497795694
Name:BUTZ, MICHAEL RAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAY
Last Name:BUTZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 COUNTRY MANOR BLVD
Mailing Address - Street 2:STE. 5
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7651
Mailing Address - Country:US
Mailing Address - Phone:406-294-9677
Mailing Address - Fax:406-294-9679
Practice Address - Street 1:1430 COUNTRY MANOR BLVD
Practice Address - Street 2:STE. 5
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7651
Practice Address - Country:US
Practice Address - Phone:406-294-9677
Practice Address - Fax:406-294-9679
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT365103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0492643Medicaid
WY1203304 00Medicaid
MT000050242Medicare UPIN